Yamane Kochi, Chen-Yoshikawa Toyofumi Fengshi
Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nagoya J Med Sci. 2025 May;87(2):368-373. doi: 10.18999/nagjms.87.2.368.
Deficiency of non-technical skills may increase the number of adverse events in the operating room. Sustained life-threatening hypotension due to intraoperative cardiac tamponade during robot-assisted thoracic surgery is rare, requiring prompt assessment and swift decision-making. A 54-year-old woman was scheduled to undergo robot-assisted thoracic surgery for an anterior mediastinal tumor. During the operation, hemodynamic instability occurred despite the administration of a high dose of vasopressor. Anesthesiologists and thoracic surgeons shared information regarding the situation, and decided to perform echocardiography and call other physicians for assistance. Cardiac tamponade was diagnosed during echocardiography, and an incision was made in the pericardium. The patient recovered from the critical situation and was extubated in the operating room. Particularly in robot-assisted surgery, non-technical skills are indispensable to enable the anesthesiologist to successfully manage critical hemodynamic instability owing to unexplained causes.
非技术技能的欠缺可能会增加手术室不良事件的发生数量。机器人辅助胸外科手术期间因术中心包填塞导致持续性危及生命的低血压情况罕见，需要迅速评估并做出快速决策。一名54岁女性计划接受机器人辅助胸外科手术以切除前纵隔肿瘤。手术过程中，尽管使用了大剂量血管升压药，仍出现了血流动力学不稳定。麻醉医生和胸外科医生就该情况共享了信息，并决定进行超声心动图检查并呼叫其他医生寻求帮助。超声心动图检查期间诊断出心包填塞，随后在心包上做了切口。患者从危急情况中康复并在手术室拔管。特别是在机器人辅助手术中，非技术技能对于麻醉医生成功处理因不明原因导致的严重血流动力学不稳定至关重要。
